The focus of outcome-based education has shifted from the process of training to the end“product”of education.This has necessitated a reframing of the teaching,learning,and assessment.Therefore,in 2013,the Accredita...The focus of outcome-based education has shifted from the process of training to the end“product”of education.This has necessitated a reframing of the teaching,learning,and assessment.Therefore,in 2013,the Accreditation Council for Graduate Medical Education(ACGME)implemented the educational milestones for all accredited residencies and fellowship programs.[1]The milestones have been described as“developmentally based,specialty-specific achievements that residents are expected to demonstrate at established intervals as they progress through training.”[1]Milestones are based on the six core competencies established by the ACGME and American Board of Medical Specialties(ABMS),which consist of medical knowledge(MK),patient care(PC),interpersonal and communication skills(ICS),practice-based learning and improvement(PBLI),professionalism(PROF),and systems-based practice(SBP).[2,3]ACGME,in conjunction with the American Board of Emergency Medicine(ABEM),drafted 23 detailed subcompetencies relevant to emergency medicine(EM).[4]展开更多
The scheduling of construction equipment is a means to realize network planning.With the large-scale and low-cost requirements of engineering construction,the cooperation among members of the engineering supply chain ...The scheduling of construction equipment is a means to realize network planning.With the large-scale and low-cost requirements of engineering construction,the cooperation among members of the engineering supply chain has become very important,and effective coordination of project plans at all levels to optimize the resource management and scheduling of a project is helpful to reduce project duration and cost.In this paper,under the milestone constraint conditions,the scheduling problems of multiple construction devices in the same sequence of operation were described and hypothesized mathematically,and the scheduling models of multiple equipment were established.The Palmer algorithm,CDS algorithm and Gupta algorithm were respectively used to solve the optimal scheduling of construction equipment to achieve the optimization of the construction period.The optimization scheduling of a single construction device and multiple construction devices was solved by using sequencing theory under milestone constraint,and these methods can obtain reasonable results,which has important guiding significance for the scheduling of construction equipment.展开更多
腹部放射学分阶段目标胜任力评价系统(The Abdominal Radiology Milestone Project),是由美国毕业后医学教育认证委员会(The Accreditation Council for Graduate Medical Education,ACGME)与美国放射学会(The American Board of Radiol...腹部放射学分阶段目标胜任力评价系统(The Abdominal Radiology Milestone Project),是由美国毕业后医学教育认证委员会(The Accreditation Council for Graduate Medical Education,ACGME)与美国放射学会(The American Board of Radiology,ABR)联合倡议发起的用于评价放射学专科医师培训考核系统的一部分,该考核评价体系考核并记录腹部放射学专科医师在培训过程中所须具备六项胜任力,包括病患关切(Patient Care,PC),医学知识(Medical Knowledge,MK),基于系统的实践(Systems-based Practice,SBP),基于实践的学习(Practice-based Learning,PBL)、职业素养(Professionalism,PROF),人际关系和沟通技巧(Interpersonal and Communication Skills,ICS)。另外,评价系统指出了多种放射亚专业评估工具,对于完善国内培训机构考核方式与内容,有着积极的指导价值。展开更多
美国眼科学住院医师Milestones评价系统是由美国毕业后教育认证委员会(the accreditation council for graduate medical education,ACGME)和美国眼科委员会(the American board of ophthalmology,ABO)根据毕业后医生的核心能力评价教...美国眼科学住院医师Milestones评价系统是由美国毕业后教育认证委员会(the accreditation council for graduate medical education,ACGME)和美国眼科委员会(the American board of ophthalmology,ABO)根据毕业后医生的核心能力评价教育质量所提出用于眼科学住院医师评价的评价系统,考核的六大核心竞争力包括患者照护、医学知识、职业素养、人际沟通、基于系统的实践和基于实践的学习,最终形成“以胜任力为基础的医学教育”。如何能够将基于培养临床胜任力的培训模式合理运用于我国眼科住院医师规范化培训体系中,并建立对眼科住院医师临床胜任力的评价与考核体系,需要进一步思考和实践。展开更多
Parkinson＇s disease （PD） neurodegenerative disease is the second most common worldwide. Since its first description as a neurological disorder by James Parkinson （1755-1824） in 1817, many important discoveries ha...Parkinson＇s disease （PD） neurodegenerative disease is the second most common worldwide. Since its first description as a neurological disorder by James Parkinson （1755-1824） in 1817, many important discoveries have been made during this 200 years of PD research history. These milestones have revealed many aspects of PD, including clinical and pathological characteristics, anatomy and neurochemistry, environmental and genetic factors,展开更多
BACKGROUND System based practice(SBP) milestones require trainees to effectively navigate the larger health care system for optimal patient care. In gastroenterology training programs, the assessment of SBP is difficu...BACKGROUND System based practice(SBP) milestones require trainees to effectively navigate the larger health care system for optimal patient care. In gastroenterology training programs, the assessment of SBP is difficult due to high volume, high acuity inpatient care, as well as inconsistent direct supervision. Nevertheless,structured assessment is required for training programs. We hypothesized that objective structured clinical examination(OSCE) would be an effective tool for assessment of SBP.AIM To develop a novel method for SBP milestone assessment of gastroenterology fellows using the OSCE.METHODS For this observational study, we created 4 OSCE stations: Counseling an impaired colleague, handoff after overnight call, a feeding tube placement discussion, and giving feedback to a medical student on a progress note. Twentysix first year fellows from 7 programs participated. All fellows encountered identical case presentations. Checklists were completed by trained standardized patients who interacted with each fellow participant. A report with individual and composite scores was generated and forwarded to program directors to utilize in formative assessment. Fellows also received immediate feedback from a faculty observer and completed a post-session program evaluation survey.RESULTS Survey response rate was 100%. The average composite score across SBP milestones for all cases were 6.22(SBP1), 4.34(SBP2), 3.35(SBP3), and 6.42(SBP4)out of 9. The lowest composite score was in SBP 3, which asks fellows to advocate for cost effective care. This highest score was in patient care 2, which asks fellows to develop comprehensive management plans. Discrepancies were identified between the fellows’ perceived performance in their self-assessments and Standardized Patient checklist evaluations for each case. Eighty-seven percent of fellows agreed that OSCEs are an important component of their clinical training,and 83% stated that the cases were similar to actual clinical encounters. All participating fellows stated that the immediate feedback was "very useful." One hundred percent of the fellows stated they would incorporate OSCE learning into their clinical practice.CONCLUSION OSCEs may be used for standardized evaluation of SBP milestones. Trainees scored lower on SBP milestones than other more concrete milestones. Training programs should consider OSCEs for assessment of SBP.展开更多
基金support via the University of Maryland School of Medicinesupport of the University of Maryland,Baltimore,Institute for Clinical&Translational Research(ICTR)the National Center for Advancing Translational Sciences(NCATS)Clinical Translational Science Award(CTSA)grant number 1UL1TR003098.
文摘The focus of outcome-based education has shifted from the process of training to the end“product”of education.This has necessitated a reframing of the teaching,learning,and assessment.Therefore,in 2013,the Accreditation Council for Graduate Medical Education(ACGME)implemented the educational milestones for all accredited residencies and fellowship programs.[1]The milestones have been described as“developmentally based,specialty-specific achievements that residents are expected to demonstrate at established intervals as they progress through training.”[1]Milestones are based on the six core competencies established by the ACGME and American Board of Medical Specialties(ABMS),which consist of medical knowledge(MK),patient care(PC),interpersonal and communication skills(ICS),practice-based learning and improvement(PBLI),professionalism(PROF),and systems-based practice(SBP).[2,3]ACGME,in conjunction with the American Board of Emergency Medicine(ABEM),drafted 23 detailed subcompetencies relevant to emergency medicine(EM).[4]
文摘The scheduling of construction equipment is a means to realize network planning.With the large-scale and low-cost requirements of engineering construction,the cooperation among members of the engineering supply chain has become very important,and effective coordination of project plans at all levels to optimize the resource management and scheduling of a project is helpful to reduce project duration and cost.In this paper,under the milestone constraint conditions,the scheduling problems of multiple construction devices in the same sequence of operation were described and hypothesized mathematically,and the scheduling models of multiple equipment were established.The Palmer algorithm,CDS algorithm and Gupta algorithm were respectively used to solve the optimal scheduling of construction equipment to achieve the optimization of the construction period.The optimization scheduling of a single construction device and multiple construction devices was solved by using sequencing theory under milestone constraint,and these methods can obtain reasonable results,which has important guiding significance for the scheduling of construction equipment.
文摘腹部放射学分阶段目标胜任力评价系统(The Abdominal Radiology Milestone Project),是由美国毕业后医学教育认证委员会(The Accreditation Council for Graduate Medical Education,ACGME)与美国放射学会(The American Board of Radiology,ABR)联合倡议发起的用于评价放射学专科医师培训考核系统的一部分,该考核评价体系考核并记录腹部放射学专科医师在培训过程中所须具备六项胜任力,包括病患关切(Patient Care,PC),医学知识(Medical Knowledge,MK),基于系统的实践(Systems-based Practice,SBP),基于实践的学习(Practice-based Learning,PBL)、职业素养(Professionalism,PROF),人际关系和沟通技巧(Interpersonal and Communication Skills,ICS)。另外,评价系统指出了多种放射亚专业评估工具,对于完善国内培训机构考核方式与内容,有着积极的指导价值。
文摘美国眼科学住院医师Milestones评价系统是由美国毕业后教育认证委员会(the accreditation council for graduate medical education,ACGME)和美国眼科委员会(the American board of ophthalmology,ABO)根据毕业后医生的核心能力评价教育质量所提出用于眼科学住院医师评价的评价系统,考核的六大核心竞争力包括患者照护、医学知识、职业素养、人际沟通、基于系统的实践和基于实践的学习,最终形成“以胜任力为基础的医学教育”。如何能够将基于培养临床胜任力的培训模式合理运用于我国眼科住院医师规范化培训体系中,并建立对眼科住院医师临床胜任力的评价与考核体系,需要进一步思考和实践。
文摘Parkinson＇s disease （PD） neurodegenerative disease is the second most common worldwide. Since its first description as a neurological disorder by James Parkinson （1755-1824） in 1817, many important discoveries have been made during this 200 years of PD research history. These milestones have revealed many aspects of PD, including clinical and pathological characteristics, anatomy and neurochemistry, environmental and genetic factors,
文摘BACKGROUND System based practice(SBP) milestones require trainees to effectively navigate the larger health care system for optimal patient care. In gastroenterology training programs, the assessment of SBP is difficult due to high volume, high acuity inpatient care, as well as inconsistent direct supervision. Nevertheless,structured assessment is required for training programs. We hypothesized that objective structured clinical examination(OSCE) would be an effective tool for assessment of SBP.AIM To develop a novel method for SBP milestone assessment of gastroenterology fellows using the OSCE.METHODS For this observational study, we created 4 OSCE stations: Counseling an impaired colleague, handoff after overnight call, a feeding tube placement discussion, and giving feedback to a medical student on a progress note. Twentysix first year fellows from 7 programs participated. All fellows encountered identical case presentations. Checklists were completed by trained standardized patients who interacted with each fellow participant. A report with individual and composite scores was generated and forwarded to program directors to utilize in formative assessment. Fellows also received immediate feedback from a faculty observer and completed a post-session program evaluation survey.RESULTS Survey response rate was 100%. The average composite score across SBP milestones for all cases were 6.22(SBP1), 4.34(SBP2), 3.35(SBP3), and 6.42(SBP4)out of 9. The lowest composite score was in SBP 3, which asks fellows to advocate for cost effective care. This highest score was in patient care 2, which asks fellows to develop comprehensive management plans. Discrepancies were identified between the fellows’ perceived performance in their self-assessments and Standardized Patient checklist evaluations for each case. Eighty-seven percent of fellows agreed that OSCEs are an important component of their clinical training,and 83% stated that the cases were similar to actual clinical encounters. All participating fellows stated that the immediate feedback was "very useful." One hundred percent of the fellows stated they would incorporate OSCE learning into their clinical practice.CONCLUSION OSCEs may be used for standardized evaluation of SBP milestones. Trainees scored lower on SBP milestones than other more concrete milestones. Training programs should consider OSCEs for assessment of SBP.
